FALL-ing into a new routine

Hellooooo readers! Fall is here and with the season it brings all things pumpkin, apples and leaves. Also…school. Yes school is in session…albeit virtual (and challenging) in many places but hopefully you have found some modicum of a routine or schedule. If you have not, don’t fret…this too shall pass. You will be racing out to the bus stop before you know it. Virtual speech therapy sessions, both private and school-based, are also in full swing. Your friendly neighborhood - nope scratch that - virtual speech therapist is here to help you navigate these murky waters.

For my parents with especially challenging scenarios (i.e. it is the Wild Wild West showdown trying to get your child to sit in front of the computer/tablet), take note: Just explain the challenge to your therapist. Mute and/or turn off the video when needed. It is ok. This way of therapy is challenging for the student and the therapist. A picture schedule is an excellent way to help children understand expectations and know when the activity is over! It can be actual pictures or line drawings: as long as your child understands that the pictorial representation signifies that particular activity. Laminate and Velcro the pictures to take off when done or simply turn it over. This makes the session concrete and shows there is a beginning and an end. If your child is a reader, you can simply write out the course of events and have him/her cross off when done. Google “picture schedules for school aged/preschool” and a plethora of ideas will pop up!

Sometimes a movement break is needed, so consider giving your child one every few minutes or after the completion of an activity. If your child is very active, try some calming activities. For example, move to a quiet area of the house with dim lighting and soft calming music. Another option is to use a weighted blanket or give a deep pressure hug while singing ABCs or a favorite nursery rhyme. If your child is more on the passive side motorically, consider some activities that are more alerting. Jumping, running, and tickling are all alerting activities to “wake up” your child. Build these movement breaks right into your child’s therapy routine. Be sure to consult with an occupational therapist if you think sensory concerns are impacting function of daily activities (Examples of these concerns include but are not limited to covering ears with noise, limited textures that the child touches or eats, extremely active or, conversely, decreased reaction to stimuli).

If your child is unable to sit for any length of time, it may be best if you (the parent) sits in on the speech session to discuss therapy strategies to incorporate into your daily routines. As the clinician, I find these sessions extremely helpful. This is especially beneficial for my school-based populations as collaboration can be difficult due to parent work and family obligations. Ask for ways that language or articulation targets can be addressed in routines that you already have in place. In this way, you can carryover goals without necessarily having to carve out time in your already busy lives. For example, make getting dressed a choice-making activity where your child can choose between 2 items of clothing or, for limited language kiddos, work on labeling and understanding labels of clothing items.

Remember that routines and reinforcement during virtual therapy is extremely important. This helps keep children motivated to participate, as they are familiar with the expectation. When all else fails, turn off the computer and use real life activities and situations to provide the lessons you are looking for from teletherapy. Your therapist is a wonderful resource in providing strategies you can use in the grocery store, playground, grandma’s house, or right in your own living room.

Welcome back!!!

Hi families! It has been a while since I have connected with you all on this platform.  The current state of affairs on global and local scales has thrust me back into writing mode…so much to say, so little characters…But I digress! 

 Well this is different! As we embark on a new school year many things are left uncertain.  From COVID protocols to remote learning, this school year will be one for the ages.  What is not left up to uncertainty is the extensive work that many school districts and private practioners have undergone to make this school year and reopening therapy offices as productive as possible.  Whether you chose to send your children to school, homeschool them, or a hybrid of the two you’ve made the right choice!  As speech therapists, therapy in the time of a pandemic has stretched creativity, patience and innovation as we look to service our most vulnerable children.  Boom Cards, Webex and Zoom have become regular lexicon in our conversations as document cameras have replaced old school projectors. 

 Teletherapy -or therapy delivered via an online platform- is not new to the profession of speech pathology but there has been a significant uptick in the usage of virtual therapy platforms to accommodate new instruction styles.  The question that begs an answer is who fits the criteria for this learning style?  Here are some bullet points to help therapists and families determine what will work for their family:

1.     In order to provide high-quality teletherapy (online speech therapy), the environment, the location, of both the student, the parent and the clinician needs to be considered. Light, seating arrangements, distractions, noise level, comfort and safety should be evaluated and modified as needed prior to beginning of a session. 

2.     Younger children working from home may need the supervision of their parents, especially in the beginning of the program. The parent may need to teach the child the basic computer skills needed for speech telepractice and help the child get ready for his or her sessions. For those who require more play-based therapy and have significantly challenged eye contact, using a non-face-to-face interaction may not be suitable.  

3.     Families should be prepared to login 5-10 minutes early or stay connected after the session to communicate with your therapist to go over any troubleshooting with the platform you are using or to discuss what is and is not working for your child.  The speech pathologist can offer strategies that may not involve virtual learning platforms if your child struggles to sit in front of a computer or tablet.

"WALLED OFF"

For the layman, the Early Intervention Program (EIP) refers to services provided to families with children from the ages of birth-3 that are found eligible to receive therapy based on decreased developmental skills.   EIP is a parent/caregiver education model and incorporates the families’ routines into therapy to help children reach developmental milestones.  For the professional, those in EIP know that this program provides invaluable resources that families may not be privy to.  The program helps to provide badly needed therapy services in many communities but probably most dire in inner cities where poverty levels are high and knowledge of the rehab professions (i.e. Speech, Occupational and Physical therapies) may be minimal.  Outpatient therapy may not be attainable due to high caseload volumes at area facilities or long waiting lists.  For some, Early Intervention is the only option, albeit a great one. 

For my colleagues: Those of us who work in these communities are provided with eye-opening insight into diverse communities.  Rich cultures and unique differences learned about families from Ecaduor to Bangladesh to Haiti highlight how varied America’s population truly is and the beauty of all of our cultures as they curiously intermingle in the realm that is Early Intervention.  For that means using jicama or biryani for feeding therapy and Masala chai tea for me after my therapy sessions depending on who I am seeing that day.

Immigrant families make up a significant percentage of the population served in the inner cities.  Some of the families have up to date documentation to be in the United States legally and some, frankly do not.  For some, the question arises as to what our role as therapists and our responsibility to the families we serve?   Regardless of the family’s immigration status it is our moral and ethical duty to provide services that we are obligated to.  That means, as hard as it may be for some, we suspend our judgment and forget where we fall on the spectrum of opinion and treat our kids.  Some ways that we can support families is to just be sounding boards because many of us don’t have answers. But for that hour that you are working with that family you can offer a sense of business as usual and a beacon of normalcy in the topsy-turvy world that they might be experiencing.   And realize that working on turn-taking or increasing utterance length may not be on the parents’ “To Do” list right now.

For my families: Know that the therapists working with you and your child are vested in his/her progress.  If you are concerned about opening your door, have the therapist call when she is outside.  Try to maintain your child’s regular schedule or routines.  And try to set aside a few minutes to work on the therapist’s suggestions, even if it is only 1 strategy you work on.  Understandably you are concerned.  Check out the website www.immigrationadvocates.org to find answers to the questions you may have regarding documentation and citizenship.

Differences aside, the impact of the current political climate on undocumented persons, their family, friends and the country as a whole is undeniable.   We must remember that the families we serve are just that, families, human beings that at the very least want a better life for themselves and their children.  Our roles as therapists frequently blur the line of support system, or trusted counselor.   Often times we are the confidants, or simply the person with knowledge of America’s cultural norms and how to navigate the system who can help during a confusing time.

Naimah Calloway, M.A., CCC-SLP is a speech pathologist in Northern New Jersey.  She owns the private practice Calloway Speech Language Services and has a speech blog under the name “Speech…In the Margins.”  Naimah received her Master’s Degree in Speech Language Pathology from Kean University and has been practicing as an ASHA certified member since 2006. She has performed community outreach to improve education about the field of Speech Pathology and has a passion for early childhood intervention, Multicultural Issues, Autism Spectrum Disorders and Feeding Disorders.

Speech...In the Margins

Hello to all my readers!  This blog is intended for parents, colleagues and paraprofessionals involved in the care of special needs children. Its intent is to shed light on how dynamic the populations we serve really are.  Speech and language disorders are no respecter of class, gender, income or nationality.  And although these disorders can affect any member of the human race, the ways in which families deal with them varies greatly.  This blog is going to highlight issues within a certain demographic, one that is easily overlooked and disregarded, even, by some. 

Families in lower socio-economic backgrounds oftentimes do not get access to the services for many reasons.  Where there is a high concentration of families with low income, other social issues can take precedence.  Sometimes getting services is just due to simply not being aware of the need of such services. Consequently, not knowing that your child can be helped may result in a delay in receiving services or not receiving therapy(-ies) at all.  Facilities that do exist in the community may have a huge waiting list, which also negatively impacts access to services.  Other times therapists may set up practices in communities where they are in a better place to earn more money.  There may even be concerns of safety and the ability to attract a financially and ethnically diverse client base.   We can propose many causes and solutions, even, but this blog’s purpose is not to point fingers or lay blame.  It is understandable that as altruistic as the best of us may be, we have to earn a living and we want our good works to be in a safe, conducive environment.

Thus, the impetus to start this blog culminated after the same kinds of issues kept arising within this population that I serve and love.   The title “In the Margins” refers to those who receive services (speech, occupational, physical therapies, ABA, Developmental Instruction, Family Training, etc.) or need services in these underserved communities and the myriad of social issues that compound a disorder.  This marginalized group is overlooked and underserved.  Their voices, rarely above a whisper in the bigger scheme of things in our society, frequently go unheard or ignored.  So as I write this blog I realize that although I live and work in this community, I sit in a “privileged position” as an insider and yet still not quite within the same constraints of the families with which I serve.  Nonetheless, I offer my insights and research as a possible resource for those who also work in these areas and those who do not.  I am no expert on social ills nor a sociologist.  I just lend my experiences as a tool to enrich and educate all of our families and colleagues.  So, happy reading and I hope you enjoy!!

Naimah Calloway, M.A., CCC-SLP is a speech pathologist in Northern New Jersey.  She owns the private practice Calloway Speech Language Services and has a speech blog under the name “Speech…In the Margins.”  Naimah received her Master’s Degree in Speech Language Pathology from Kean University and has been practicing as an ASHA certified member since 2006. She has performed community outreach to improve education about the field of Speech Pathology and has a passion for early childhood intervention, Multicultural Issues, Autism Spectrum Disorders and Feeding Disorders.